Model for End-Stage Liver Disease Score Predicts the Mortality of Patients with Coronary Heart Disease Who Underwent Percutaneous Coronary Intervention

Abstract

Background. Coronary heart disease (CHD) is caused by the blockage or spasm of coronary arteries. Evidence shows that liver disease is related to CHD. However, the correlation between the Model for End-Stage Liver Disease (MELD) score and outcomes in patients after percutaneous coronary intervention (PCI) was unclear. Method. A retrospective cohort study involved 5373 patients with coronary heart disease after PCI was conducted from January 2008 to December 2016. Participants were classified to four groups according to the MELD score by quartiles. The primary endpoint was long-term mortality including all-case mortality (ACM) and cardiac mortality (CM). Secondary endpoints included bleeding events, readmission, major adverse cardiovascular events (MACE), major adverse cardiovascular, and cerebrovascular events (MACCE). The longest follow-up time was almost 10 years. Results. There were significant differences in the incidences of ACM ( p = 0.038 ) and CM ( p = 0.027 ) among the four MELD groups, but there was no significant difference in MACEs ( p = 0.496 ), MACCEs ( p = 0.234 ), readmission ( p = 0.684 ), and bleeding events ( p = 0.232 ). After adjusting the age, gender, smoking, drinking status, and diabetes by a multivariable Cox regression analysis, MELD remains independently associated with ACM (HR:1.57, 95%CI 1.052–2.354, p = 0.027 ) and CM (HR:1.434, 95% CI 1.003–2.050, p = 0.048 ). Conclusion. This study indicated that the MELD score had a strong prediction for long-term mortality in CHD patients who underwent PCI.

Prognostic Value of Different Versions of the Model for End-Stage Liver Disease Score in Patients Undergoing Percutaneous Coronary Intervention

“…Chen et al retrospectively evaluated 5373 patients with CAD treated with PCI and suggested that the MELD score was an independent predictor of long-term all-cause mortality and cardiac mortality. 6 Similarly, a high MELD score was found to have considerable predictive power in assessing long-term mortality during a median follow-up of 28 months in patients with acute coronary syndrome who were not treated with prior anticoagulation. 7 Moreover, some studies have focused on the associations between modified versions of the MELD score and poor cardiovascular outcomes.…”

“…Recently, several studies have demonstrated that the MELD score and its 3 modifications were associated with poor cardiovascular prognosis. [6][7][8][9][10][11][12] However, the prognostic performance of these scores in patients with CAD undergoing elective PCI is currently understudied. The present study evaluates and compares the accuracy of the MELD score and its 3 modifications for prognostic estimation in patients undergoing elective PCI.…”

Ultrasonographic assessment of cardiac function and disease severity in coronary heart disease

“…Coronary heart disease (CHD), a clinical multiple cardiovascular disease mainly caused by coronary artery atherosclerosis[ 1 ], leads to vascular lumen obstruction or stenosis and, eventually, to myocardial hypoxia and ischemia. CHD causes many adverse cardiovascular events and, without timely intervention, poses a threat to the patient’s health and quality of life [ 2 - 4 ].…”